Signup

Participant Information:

Name: {name}

Address: {address}

Phone Number: {phone}

Email:

Acknowledgment of Risks:

I acknowledge that participating in fitness activities at The Whole You Wellness Studio involves inherent risks, including, but not limited to, physical injury, medical conditions, and accidents. I voluntarily assume all risks associated with my participation.

Medical Clearance:

I certify that I am physically fit and have no medical conditions that would prevent my participation in the activities offered by The Whole You Wellness Studio. I agree to notify the staff of any changes to my health that may affect my ability to safely participate.

Release of Liability:

I release, waive, discharge, and covenant not to sue The Whole You Wellness Studio, its owners, officers, employees, and agents from any and all liability, claims, demands, actions, and causes of action arising out of or related to any loss, damage, or injury, including death, that may be sustained by me, or to any property belonging to me, while participating in activities or using the facilities.

I agree to indemnify and hold harmless The Whole You Wellness Studio from any loss, liability, damage, or costs, including court costs and attorney fees, that they may incur due to my participation in activities.

Content Creation and Media Release:

I understand that The Whole You Wellness Studio produces content of classes and events, which may include photography, video, and other media. I acknowledge that I may be included in this content and give my permission for my likeness to be used in promotional materials, social media, and other media formats.

Permission for Progress or Transformation Photos:

The Whole You Wellness Studio will seek my explicit permission prior to posting any progress or transformation photos. I am aware of this practice and agree to communicate my preferences clearly.

Opt-Out of Media Inclusion:

I understand that if I do not wish to be heavily included in content creation, I need to make this clear to the staff, and my preferences will be respected.

Emergency Contact:

Name: {contact_name}

Relationship: {contact_relation}

Phone Number: {contact_phone}

By signing below, I acknowledge that I have read, understood, and agree to the terms of this waiver and release of liability.

Signature:

Date: {sign_date}

Physical Activity Readiness Questionnaire (PAR-Q)

Participant Information:

Name: {name}

Date of Birth: {dob}

Phone Number: {phone}

Email:

Please read the questions carefully and answer each one honestly: check YES or NO.

Has your doctor ever said that you have a heart condition and that you should only do physical activity recommended by a doctor?

Do you feel pain in your chest when you do physical activity?

In the past month, have you had chest pain when you were not doing physical activity?

Do you lose your balance because of dizziness or do you ever lose consciousness?

Do you have a bone or joint problem that could be made worse by a change in your physical activity?

Is your doctor currently prescribing drugs (for example, water pills) for your blood pressure or heart condition?

Do you know of any other reason why you should not do physical activity?

If you answered YES to one or more questions:

Talk with your doctor by phone or in person BEFORE you start becoming much more physically active or BEFORE you have a fitness appraisal. Tell your doctor about the PAR-Q and which questions you answered YES to.

You may be able to do any activity you want – as long as you start slowly and build up gradually. Or, you may need to restrict your activities to those that are safe for you. Talk with your doctor about the kinds of activities you wish to participate in and follow their advice.

If you answered NO to all questions:

You can be reasonably sure that you can start becoming much more physically active – begin slowly and build up gradually. This is the safest and easiest way to go.

You can take part in a fitness appraisal – this is an excellent way to determine your basic fitness so that you can plan the best way for you to live actively.

Informed Consent

Please read and sign the following consent form.

I have read, understood, and completed this questionnaire. Any questions I had were answered to my full satisfaction.

Name:

Signature: ________________________________

Date: {sign_date}

Note: This PAR-Q form is a guideline and should be reviewed by a medical professional to ensure it meets the specific needs and legal requirements of your fitness facility.